Tuesday, April 5, 2016

Social-Context Factors, Refusal Self-Efficacy, and Alcohol Use among Female Sex Workers in China

Excessive alcohol use is
considered as a health risk behavior that may produce negative health outcomes.
Examining predictors of alcohol use in a social or individual context can
advance understanding of why people indulge in alcohol use.

Our research on female
sex workers (FSWs) examined associations among several social-context factors
(alcohol use by family members, alcohol use by peers, and client-perpetrated
pressure or violence), refusal self-efficacy, and alcohol use.

Seven hundred
FSWs were recruited from two cities in Southern China. Structural equation
modeling (SEM) was used to analyze the direct effects of alcohol use by family
members, alcohol use by peers, and client-perpetrated pressure or violence on
FSWs’ alcohol use. In addition, the mediation effects of refusal self-efficacy
were also examined in the SEM model.

Results showed that alcohol use by family
members and alcohol use by peers significantly predicted FSWs’ alcohol use; the
prediction effect of alcohol use by peers on FSWs’ alcohol use was stronger
than that of alcohol use by family members; client-perpetrated pressure or
violence directly predicted FSWs’ alcohol use and indirectly influenced FSWs’
alcohol use through refusal self-efficacy; refusal self-efficacy directly
predicted FSWs’ alcohol use. Administrators of effective intervention programs
focused on alcohol use in China should adopt a multilevel approach to reduce
negative social influences, particularly the influence from peer, and sex work
establishments on FSWs’ alcohol use.

Meanwhile, training to improve refusal
self-efficacy should also be included in intervention programs to reduce FSWs’
alcohol use.

Below: Associations among social-context factors, refusal self-efficacy and alcohol use of FSWs (N=688)